Provider Demographics
NPI:1073004776
Name:WOODS, MARSHA M
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:M
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67925 BAYBERRY DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ST. CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950
Mailing Address - Country:US
Mailing Address - Phone:740-526-0204
Mailing Address - Fax:740-526-0207
Practice Address - Street 1:67925 BAYBERRY DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:ST. CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950
Practice Address - Country:US
Practice Address - Phone:740-526-0204
Practice Address - Fax:740-526-0207
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1701484104100000X
OHI.20022531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker